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Shock due to faecal impaction
  1. Ji Soo Baik1,
  2. Timothy Seers1,
  3. Sabeena Qureshi2,
  4. Simon Nadel2
  1. 1 Imperial College Faculty of Medicine, Imperial College London, London, UK
  2. 2 Paediatric Intensive Care Unit, St Mary’s Hospital, London, UK
  1. Correspondence to Dr. Simon Nadel, Paediatric Intensive Care Unit, St Mary’s Hospital, Praed Street, London W2 1NY, London, UK; s.nadel{at}

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A 15-year-old boy with quadriplegic cerebral palsy presented with a 2-day history of profuse diarrhoea and a 12-hour history of ‘coffee-ground’ vomiting. He had a prolonged history of poorly controlled constipation and diarrhoea, treated with regular movicol.

The patient was hypotensive, with metabolic acidosis and hyperlactaemia, and was therefore intubated and ventilated and needed fluid resuscitation and inotropic support. Investigations revealed C reactive protein 350 mg/L and white cell count 30×1012/L. …

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